“…Researchers have also linked IP use with arousal, attraction, and sexual performance problems, including difficulty orgasming and erectile dysfunction (ED) (Sutton, Stratton, Pytyck, Kolla, & Cantor, 2015;Wéry & Billieux, 2016;Voon et al, 2014, Porto, 2016, negative effects on partnered sex (Poulsen, Busby, & Galovan, 2013;Sun, Bridges, Johnason, & Ezzell, 2014), a need for stronger pornographic material (Wéry & Billieux, 2016), and a preference for using IP to achieve and maintain arousal rather than having sex with a partner (Sun, Miezan, Lee, & Shim, 2015). In the latter study, users with increased interest in degrading or extreme IP also had the greatest concerns about their sexual performance, penis size, and ability to sustain an erection (Sun et al, 2015), suggesting their IP use may have fueled a need for more extreme stimulation.…”